RESUMEN
OBJECTIVE: To determine whether surgery in patients with mesial temporal lobe epilepsy (mTLE) is associated with reduced brain-predicted age as a neural marker overall brain health, we compared brain-predicted and chronologic age difference (brain age gap estimation [BrainAGE]) in patients before and after surgery with healthy controls. METHODS: We acquired 3D T1-weighted MRI scans for 48 patients with mTLE before and after temporal lobe surgery to estimate brain age using a gaussian processes regression model. We examined BrainAGE before and after surgery controlling for brain volume change, comparing patients to 37 age- and sex-matched controls. RESULTS: Preoperatively, patients showed an increased BrainAGE of more than 7 years compared to controls. However, surgery was associated with a mean BrainAGE reduction of 5 years irrespective of whether or not surgery resulted in complete seizure freedom. We observed a lateralization effect as patients with left mTLE had BrainAGE values that more closely resembled control group values following surgery. CONCLUSIONS: Our findings suggest that while morphologic brain alterations linked to accelerated aging have been observed in mTLE, surgery may be associated with changes that reverse such alterations in some patients. This work highlights the advantages of resective surgery on overall brain health in patients with refractory focal epilepsy.
Asunto(s)
Envejecimiento Prematuro , Epilepsia Refractaria , Epilepsia del Lóbulo Temporal , Adolescente , Adulto , Anciano , Envejecimiento Prematuro/diagnóstico por imagen , Envejecimiento Prematuro/etiología , Envejecimiento Prematuro/patología , Envejecimiento Prematuro/cirugía , Epilepsia Refractaria/complicaciones , Epilepsia Refractaria/diagnóstico por imagen , Epilepsia Refractaria/patología , Epilepsia Refractaria/cirugía , Epilepsia del Lóbulo Temporal/complicaciones , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia del Lóbulo Temporal/patología , Epilepsia del Lóbulo Temporal/cirugía , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Adulto JovenRESUMEN
Pachydermoperiostosis is a rare syndrome that hinders patients' quality of life thru its aesthetics manifestations and functional obstacles. Many techniques for addressing and correcting aesthetic defects associated with pachydermoperiostosis have been introduced, including facelift surgery. This case presentation includes treatment of facial pachydermoperiostosis and restoration of facial aesthetics via treatment with facelift, skin muscle excision, and botulinum toxin A.
Asunto(s)
Inhibidores de la Liberación de Acetilcolina/uso terapéutico , Envejecimiento Prematuro/cirugía , Toxinas Botulínicas Tipo A/uso terapéutico , Técnicas Cosméticas , Osteoartropatía Hipertrófica Primaria/cirugía , Ritidoplastia/métodos , Estética , Músculos Faciales/cirugía , Estudios de Seguimiento , Humanos , Masculino , Calidad de Vida , Rejuvenecimiento , Adulto JovenAsunto(s)
Envejecimiento Prematuro/cirugía , Osteoartropatía Hipertrófica Primaria/cirugía , Procedimientos de Cirugía Plástica/métodos , Ritidoplastia/métodos , Adolescente , Envejecimiento Prematuro/diagnóstico , Terapia Combinada , Estética , Humanos , Masculino , Osteoartropatía Hipertrófica Primaria/diagnóstico , Satisfacción del Paciente , Medición de Riesgo , Envejecimiento de la Piel , Resultado del TratamientoRESUMEN
OBJECTIVE: To introduce a safe, effective and lasting rhytidectomy technique without destroying the configuration of sideburn. METHODS: The operation is performed through the coronal incision, the temporal incision that is paralleled to the nasolabial sulcus, and the preauricular incision in the sideburn. Multi-layer dissection of facial tissue is made. RESULTS: 46 patients with aging face have been treated using this technique since 2002. All patients obtained good curative effects without any severe complications. CONCLUSIONS: This operation technique may maintain the natural configuration of the preauricular area and sideburn, result obscure incision scar and avoid harming important nerves or vessels. Multi-layer dissection accords with anatomical principles and produces a lasting curative effect.